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Dry skin on hands,cracked,bleeding

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Dermatologist
Practicing since : 1996
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Hi, Since last year, I have a persistently growing dry skin problem on my hands, they get cracked and bleeding if I leave them alone. What will cure this?
Posted Mon, 30 Apr 2012 in Skin Hair and Nails
 
 
Answered by Dr. Bharat Chawda 8 hours later
Hi!,

Thank you for the query,

I am happy to understand that you don't have any medical ailments except the skin problem.

I would like to ask few things here before answering your questions:
1) Is the peeling of skin specifically over palms or the whole arm.
2) What soap do you prefer using for hands.
3) Do you suffer from thyroid problem (since that can cause dry skin).
4) Do you come in contact with detergents.
5) Have you tired any medication for this problem till now .
6) Do you do gardening or come in contact with any chemicals at home or at work place.

According to the description it seems to be a dry eczema(also known as house wife eczema).
To begin with I would prefer a course of antibiotics to take care of the cuts .Along with this you need a good moisturizer which should be used 4-5 times in the day.

You should also use a moisturizing soap for hands(the one that contains glycerin) .Moisturizers should be used immediately after washing hands over the wet skin .This would help trap the water underneath with a film of oil above it.For the cuts you can use any good antibiotic cream (I would prefer mupirocin) .

Once the cuts have healed you can start off with a steroid cream locally 2-3 times a day.You can also take a course of anti-histaminics if you have itching.

Kindly avoid frequent washing of hands and also avoid use of drying soaps .
Also avoid coming in contact with detergents or any fertilizers (if at all you are dealing with).

If you can send me a close up picture of the lesion then probably I can help you further in this.You can send it at YYYY@YYYY do mention "ATTN Dr.Bharat chawda" as subject.Also kindly reply to this post saying that you have mailed a picture.

Kindly reply me with the answers & the picture as this will help me in suggesting you better.

regards,
Dr.Bharat chawda

Above answer was peer-reviewed by
 
Follow-up: Dry skin on hands,cracked,bleeding 2 days later
Hello Dr. and Thank you for your prompt response, ir was difficult trying to find someone to take pictures of my hands but I will send them by email as soon as I finish writing this to you... To answer your questions...
1) It started in my right palm and now has spread to my fingers, not on my arms.
2)I use an anti-bacterial soap (Dawn) to wash my hands - I am a child care provider and I'm always washing my hands.
3) I don't know if I have a thrroid problem.
4)Like I mentioned before - I am constantly washing my hands.
5) I went to urgent care and the doctor there gave me some Triamcinolone Acetonide Cream - I used it sparingly but it didn't seem to work.
6)No gardening and the only chemicals are the anti-bacterial soap.

I have been using Neosporin on a bandage for overnight relief, but then it gets dried out again.
I have been using 2 lotions (Gold Bond & Curel) both have Glycerin at least 3-4 times daily.
Is mupirocin over-the-counter or will Neosporin do the same?
And what do I use for a steroid cream?
And yes, I have itching, what do I use for an anti-histaminic?
I am sending you pictures in an email "Kathy's Hands"

Regards, XXXXXXX W.
 
 
Answered by Dr. Bharat Chawda 1 hour later
Dear XXXXXXX

Thank you for the reply,

You have nicely described each points and with these points in mind, I still see the possibility of allergic contact dermatitis or eczema (if both palms are involved). The reasons for this would be as follows:
1) Since you frequently wash your hands.
2) Use of antibacterial soap.
3) even neosporin is not good here as neosporin itself can lead to allergy and aggravate the problem.
4) presence of cracks and bleeding .
5) presence of itching.

My advise here (in allergic contact dermatitis) would be to avoid frequent washing of hands and that too with any anti-bacterial soap. I am never in favor of using anti-bacterial soaps, instead use good moisturizing soap (the one with glycerin would do).

Also avoid use of neosporin cream, as we in our practice often come across allergies to neosporin cream. Muporocin would be the best. The laws for OTC drugs are different in each country,so I have very less idea about that in your country. You can find it out with any chemist shop nearby.

You definitely need a topical steroid here, but hydrocortisone would be very mild one .You can use any mid-high potent topical steroid over hands. 'Clobetasole' preparations are good.
Since you have developed cracks which are bleeding too, you also would need a oral antibiotic drug to take care of any secondary infection.

Frequent use of a good moisturizer is also recommended.

For itching you can use any anti-histamine available.

I wold recommend to consult a dermatologist who can confirm the diagnosis and help you in management too.

I hope I've answered your query.

Wish you good health.

Regards,
Dr.Bharat chawda
Above answer was peer-reviewed by
 
Follow-up: Dry skin on hands,cracked,bleeding 21 hours later
I was under the impression that if I needed a prescription that you could prescribe it for me. Are you in another country other than U.S.?
Thanks, XXXXXXX W.
 
 
Answered by Dr. Bharat Chawda 1 hour later
Hi,

Thanks for writing back.

I can only help in suggesting you a possibility in any case.Secondly any doubts regarding the treatment taken can also be discussed .I can even suggest a treatment,but it would be unethical and inappropriate to prescribe you any scheduled drugs without doing a proper clinical examination(which can be done only in person).Under medical laws we doctors are not supposed to suggest any trade name of any medicine in the net.We can give only our expert opinions and guide you in course of your treatment.Its just like giving a second opinion.
Yes I am not in U.S.
As a patient ,I truly understand your need ,but it would be wise to consult a doctor in person and take a prescription.These are prescribed medicine and not OTC ,so without a proper prescription these medicines are not dispensed by any chemist shop either.
I hope you would understand my limitations here .

wish you good health.

regards,
Dr.Bharat Chawda

Above answer was peer-reviewed by
 
Follow-up: Dry skin on hands,cracked,bleeding 3 hours later
I understand your limitations, I wish I knew them prior to this...But You have helped me greatly, I have stopped washing my hands so often and no more anti-bacterial soap. I spread Neosporin on my hands last night and then put on gloves and it helped, then spread moisturizers on later, it seems to be helping. I can't afford a doctor office visit, that's why I came here.
On the other issues, I have to see what I can do...
 
 
Answered by Dr. Bharat Chawda 9 hours later
Hi!Kathy,

I am happy to hear that the advise is helping you .

If I am not wrong mupirocin cream for cuts on hands should be a OTC cream .Please check it out at any chemist shop.

Topical steroid in combination with antibiotic is what you need next .Clobetasole with gentamycin would be the best choice.Now this should be a prescription based cream.

If you take all the precautions, probably ,but gradually ,you would heal good,even without much medicines.

In case you need any advise , kindly write back to us.

wish you good health.
regards,
Dr.Bharat chawda


Above answer was peer-reviewed by
 
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